We love ACT teams! But, where are they? In a previous post, we talked about what an Assertive Community Treatment (ACT) team is.  We discussed who the members of the team are? We listed eligibility for the services. And finally, we listed the ACT services.

team ACT

As we continue to build out the mental health system in Iowa, the continued frustration I hear most often is that “a service is not available in my area”. Or, “I cannot get into the program”. Finally, one big complaint is that the service is inconsistently delivered across Iowa.

This post focuses on where ACT teams are located and what they look like based on published regional reports and information. We provide links to the reports for your review and additional information.

What Regions have ACT teams?

Central Iowa Community Services:

Eyerly Ball Community Mental Health Services is implementing ACT services in Story and Boone counties in FY 18. CICS is researching rural ACT services and will be exploring further implementation of ACT services in FY 19.

County Rural Offices of Social Services:

In FY 17 CROSS contracted with Resources for Human Development (RHD) to provide a rural Assertive Community Treatment (ACT) program to fidelity. As of February 2018, the program had 28 individuals receiving services. The CROSS Region is currently working with two neighboring MHDS Regions to expand our ACT team to Appanoose, Madison and Warren counties as we continue to work toward a full census of 50 clients.

County Social Services:

Has budgeted $300,000 in FY 2019 for this service. No specifics listed as to where the program is currently located.

Eastern Iowa MHDS region:

Vera French Community Mental Health center in Davenport

Heart of Iowa Region:

There was no money in the budget for this service in FY 2019

MHDS of the East Central Region:

There was no money in the budget for this service in FY 2019

Northwest Iowa Care Connections:

Seasons Center provides a rural ACT team in the region.

Polk County Health Services:

Eyerly Ball Community mental health center

Rolling Hills Community Services Region:

There was no money in the budget for this service in FY 2019

Sioux Rivers MHDS:

There was no money in the budget for this service in FY 2019

South Central Behavioral Health Region:

Going forward in FY 2019, the region will be looking a developing/contracting for an ACT team that can help in the assistance of mental health clients that could benefit from this service in Appanoose County. In FY 19 SCBHR will be working alongside of Southern Iowa Mental Health Center to develop an ACT for Wapello County Davis County

Southeast Iowa Link:

There was no money in the budget for this service in FY 2019

Southern Hills Regional Mental Health:

There was no money in the budget for this service in FY 2019

Southwest Iowa MHDS Region:

There was $100,000 in the budget for this service in FY 2019 but no indication of the location of the service.

Since the passage of the complex needs legislation, the regions have been tasked to continue building out this service throughout Iowa.

Challenges in Development

As a reminder, there are a few challenges in development especially in the more rural regions. Challenges include workforce shortages and population to sustain ongoing programming. Another challenge facing development is the managed care decision to fund only 5 days a week of a 7 day a week program. This decision puts added pressure on regions to financially support the service long term.

ACT services are available in Iowa. But, at present, we cannot say they are equally distributed or available statewide. The state will continue to push for development of services and seek Medicaid payment as stated in the Iowa code.

Discussion:

What other challenges do you see in development of these services?